Jackson Davenport INC.
Jackson Davenport INC. was paid $57K by Medicaid between Jan 2018 and Dec 2021, across 8 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 41% of everything it billed.
33Billing provider infoJACKSON DAVENPORT INC.
CHARLESTON, SC 29401
CHARLESTON, SC 29401
33aNPI1073688602assigned 11/21/2006
33bProvider typeContact Lens Fitter
28Total paid$57K
24GClaims2,320
24DCodes billed8
24AFirst – last monthJan 2018 – Dec 2021
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,058 | $28K | |
| 2019 | 1,067 | $25K | |
| 2021 | 195 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 41% | 366 | 364 | $23K |
| 92015 | Determination of refractive state | 24% | 674 | 657 | $14K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 20% | 850 | 832 | $11K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 9.2% | 64 | 60 | $5K |
| V2025 | Deluxe frame | 2.2% | 30 | 29 | $1K |
| V2756 | Eye glass case | 2.0% | 281 | 277 | $1K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 1.3% | 35 | 28 | $728.00 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 20 | 16 | $92.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialDAVENPORT, NANCY (MANAGER)